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find Author "金日浩" 3 results
  • UPPER LIMB FREE FLAP FOR REPAIR OF SEVERE CONTRACTURE OF THUMB WEB AND ONE STAGE RECONSTRUCTION OF INDEX FINGER ABDUCTION

    ObjectiveTo evaluate the effectiveness of the upper limb free flap for repair of severe contracture of thumb web, and one stage reconstruction of the index finger abduction. MethodsBetween March 2007 and June 2011, 16 cases of severe contracture of thumb web and index finger abduction dysfunction were treated. There were 14 males and 2 females with an average age of 29 years (range, 16-42 years). All injuries were caused by machine crush. The time between injury and admission was 6-24 months (mean, 10 months). The angle of thumb web was 10-25° (mean, 20°), and the width of thumb web was 15-24 mm (mean, 22 mm). After scar relax of the thumb web, the defect size ranged from 6 cm × 4 cm to 8 cm × 6 cm; the upper limb free flap from 7 cm × 5 cm to 9 cm × 7 cm was used to repair the defect, index finger abduction was simultaneously reconstructed by extensor indicis proprius tendon transfer. The donor site was repaired with skin grafting. ResultsAll the flaps and skin graftings survived after operation and incisions healed by first intention. Fourteen patients were followed up 6-12 months (mean, 9 months). The flap appearance was satisfactory. The two-point discrimination was 6-9 mm (mean, 7 mm) after 6 months. The angle of thumb web was 85-90° (mean, 88°). The width of thumb web was 34-52 mm (mean, 40 mm). The abduction and opposing functions of thumb and abduction function of index finger were both recovered. Conclusion A combination of the upper limb free flap for severe contracture of thumb web and one stage reconstruction of the index finger abduction for index finger abduction dysfunction can achieve good results in function and appearance.

    Release date:2016-08-31 05:39 Export PDF Favorites Scan
  • CLINICAL APPLICATION OF PERONEAL MUSCLES TENDON TRANSPOSITION IN REPAIR OF ACHILLES TENDON RUPTURE

    Objective To discuss applied anatomy, biomechanics and surgical procedures of long peroneal muscles tendon transposition in repair of occlusive achilles tendon rupture. Methods The blood supply and the morphology of long peroneal muscles tendon were observed in the lower extremity of 50 sides adult specimens and the mechanical tests which stretch load on the tendon were carried out. The methods were designed on the basis of the anatomical characteristics and morphology. Ten patients suffering occlusive Achilles tendon rupture were treated by using long peroneal muscles tendon transposition from March 2001 to July 2004. Among 10 patients, there were 7 males and 3females, aging 32 to 54 years including 6 cases of jump injury, 2 cases of bruise, 1 case of step vacancy and 1 case of spontaneity injury. The interval between injury and surgery was 6 hours to 7 days in 7 fresh rupture and 21 days to 3 months in 3 old rupture. All cases belonged to occlusive Achilles tendon rupture(8 cases of complete rupture and 2 cases of incomplete rupture). Results The origin of long peroneal muscles was proximal tibia and fibular head, the end of them was base of first metatarsal bones and medial cuboid. The length of tendon was 13.5±2.5 cm. The width of origin tendon was 0.9±0.2 cm and the thickness was 0.3±0.1 cm; the width on apex of lateral malleolus was 0.7±0.1 cm and the thickness was 0.4±0.1 cm, the width on head of cuboid was 0.7±0.1 cm and the thickness was 0.3±0.1 cm. The long peroneal muscles tendon had abundant blood supply. The results of mechanical test showed that the biggest load was 2 292.4±617.3 Non tendon calcaneus, 1 020.4±175.4 N on long peroneal muscles tendon, 752.0±165.4 N on peroneus brevis tendon and 938.2±216.7 N on tibialis posteriortendon. Tencases of occlusive Achilles tendon rupture achieved healing by first intention and were followed up 1824 months. No Achilles tendon rerupture, necrosis of skin or other complications occurred. According to AmerLindholm criterion forcurative results, the results were excellent in 7 cases and good in 3 cases and the excellent and good rate was 100%. Conclusion The long peroneal muscles tendon transposition is a perfect and simple way to repair occlusive Achilles tendon rupture.

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • 膝上外侧动脉嵌合穿支皮瓣修复第一掌背复合组织缺损

    目的总结膝上外侧动脉嵌合穿支皮瓣修复第1掌背复合组织缺损的疗效。 方法2008年3月-2012年12月,采用膝上外侧动脉嵌合穿支皮瓣修复第1掌背复合组织缺损5例。男4例,女1例;年龄16~42岁,平均29岁。机器挤压伤2例,机器压砸伤3例。皮肤软组织缺损范围4 cm×3 cm~7 cm×6 cm;骨缺损范围1.4 cm×1.3 cm~2.4 cm×1.6 cm;肌腱缺损长度2~4 cm。术中骨瓣切取范围1.5 cm×1.4 cm~2.5 cm×1.8 cm,皮瓣切取范围5 cm×4 cm~8 cm×7 cm;髂胫束切取长度3~5 cm。1例同时行环指屈指浅肌腱转移重建拇外展功能。供区直接缝合。 结果术后皮瓣均成活,创面Ⅰ期愈合;供区切口均Ⅰ期愈合。5例均获随访,随访时间6~12个月,平均8个月。皮瓣质地柔软;骨愈合时间3~5个月,平均4个月。术后6个月,根据中华医学会手外科学会上肢部分功能评定试用标准评定:优3例,良2例。供区无瘢痕挛缩,无活动障碍。 结论膝上外侧动脉嵌合穿支皮瓣可一期修复第1掌背复合组织缺损,有利于早期功能锻炼,促进手部功能恢复,供区损伤小。

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